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Individual

JAY H GASSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
300 N HOSPITAL DR, PRICE, UT 84501-4218
(800) 748-4868
(801) 733-5872
Mailing address
422 CANYON VIEW DR, PLEASANT GROVE, UT 84062-4571
(801) 796-3546

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
199347-4406
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107008681104
IHC
UT
01
2000575
UNITED HEALTHCARE
UT
01
343841
DESERET MUTUAL
UT
01
7561
HEALTHY U
UT
01
76565
PEHP
UT
01
PRA02133
MOLINA
UT
01
QM0000076612
ALTIUS
UT
Enumeration date
08/20/2006
Last updated
07/08/2007
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